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LocationAspheric ReStor Lens Implant
Designed to Address Presybopia.
Aspheric ReStor Lens Implant
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The Aspheric IQ lens is designed to enhance contrast sensitivity, reduce dependency on glasses, and improve functional vision. The Aspheric IQ lens offers these advantages over traditional intraocular lens implants:
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It’s a huge evolutionary step. We all want a glasses-free and contact lens-free society and we are very rapidly moving toward that. Reducing the need for reading glasses after cataract removal, without compromising distance vision, has been a goal of ophthalmology for many years. Until now, the vast majority of patients who undergo cataract surgery received a single-vision lens implant, which typically requires them to carry around reading glasses so they can read a newspaper, menu or medicine bottle, or do other things that require close vision.
Aspheric Design Advantage
Traditional lens implants are spherical, meaning the front surface is curved. Aspheric ReStor lens is slightly flatter in the periphery and are designed to provide better contrast sensitivity.
The AcrySof Aspheric ReSTOR lens is a permanent artificial lens used to replace the natural lens during cataract surgery. The ReStor lens is convex on both sides and made of a soft plastic. It is folded and inserted into the eye through a tiny incision smaller than the optic diameter of the lens. After insertion, the lens gently unfolds to “ReStor” vision. The supporting arms of the lens maintain proper positioning within the eye.
Meeting the Challenge of Presbyopia
| The ability to focus at various distances is called ‘accommodation’, and is the normal condition of a youthful natural lens. However, as we age, this lens becomes more rigid and our ability to accommodate diminishes, usually starting around the age of forty. This inability to accommodate is called Presbyopia. Presbyopia is the reason that reading glasses or bifocals are required as we age. |  |
Aging also causes the eye’s natural lens to become more opaque, which scatters light and creates cloudy vision. The opaque lens is called a cataract. Traditionally, when a cataract develops, the natural lens inside the eye is replaced with an artificial IOL. Standard IOL’s are single-vision lens, which allow perfect vision without glasses for one distance only, usually for distance. Glasses would still be needed for near vision.
Apodization – An Entirely Unique Design
The ReStor lens has a uniquely shaped optic, called “apodization,” that is entirely new to the field of ophthalmology. The Aspheric ReStor IOL represents breakthrough technology because it treats the refractive problem of Presbyopia. It delivers consistent high-quality accommodative-like vision across the entire visual spectrum due to its patented apodized design.
While other accommodative-type IOL’s produce vision at various ranges by depending on the action of the eye’s ciliary muscles to produce accommodation, the ReStor lens responds to how wide or small the eye’s pupil to distribute light between near and far vision. Having both “refractive” and “diffractive” surfaces, the ReStor lens works like two lenses in one. The refractive surface is for distance and the diffractive surface is for near. This amazing combination renders a lens implant that is not dependent on the movement of the lens, making visual outcomes more highly predictable.
Apodization is the gradual tapering of the diffractive steps from the center to the outside edge of a lens. This unique design optimally manages light energy delivered to the retina because it distributes the appropriate amount of light to near and distant focal points, regardless of the lighting situation. Apodized diffractive optics are designed to improve image quality while minimizing visual disturbances. The result is an increased range of quality vision that delivers a high level of spectacle freedom.
Diffraction involves the diffusing or bending of light to multiple focal points as it passes through the lens. The center diffractive area of the ReStor supports near vision. The center of the lens surface consists of an “apodized” diffractive optic, a series of tiny steps in that center area working together to focus light for a seamless transition of near through distance vision.
Refraction involves the redirection of light passing through the lens, to a single focus point on the retina. The outer ring of the ReStor is the refractive area that surrounds the apodized diffractive region and is what allows you to experience distance vision.
Previous attempts using various multifocal lenses often resulted in haloes and significantly reduced contrast sensitivity in low light conditions. These issues are no longer a problem with the ReStor lens. As well, unlike the blended vision monofocal implant option; there is no loss of depth perception. Reading ability, even for fine print, is markedly improved with the ReStor.
Is the ReStor lens for everyone?
The best candidates will be those that have a strong desire to see well without glasses and have realistic expectations. While there are no known contraindications, based on the FDA clinical trials, the following types of patients should NOT have the Aspheric ReStor lens:
- Patients who are satisfied with wearing glasses
- Patients who want guarantees on surgical outcomes
- Patients that are hypercritical with unrealistic expectations
- Patients with excessive complaints about their prescription
- Patients who drive at night for a living, or whose occupation or hobbies depend on good night vision
- Patients who are amateur or commercial airline pilots
- Patients who have lifelong complaints about glare and halos or are bothered by glare at night
- Patients with ocular disease may not be good candidates for this implant.
Astigmatism is not corrected with standard cataract surgery nor with the ReStor lens, but it may be address with the AcrySof Toric IOL.
Medicare Approval of the Aspheric ReStor Lens
Medicare has announced revisions to its payment guidelines, allowing patients covered for cataract surgery to choose the ReStor lens at an added fee. Previously, Medicare payment rules did not allow patients to choose this lens, which is highly significant since the lens was specifically designed for this age group!
The ReStor lens, and the care associated with the surgery to implant it, is unique for Medicare recipients because it treats the non-covered refractive diagnosis of Presbyopia. For the first time, Medicare is now allowing patients to choose this elective refractive service. Patients with cataracts will still have their basic surgery covered by Medicare and/or insurance, plus they may elect to pay out of pocket for the upgrade of the ReStor lens and Presbyopia treatment.
Refractive lens exchange, surgery patients without cataracts (who also wish to be independent of glasses) would be responsible for the whole fee as usual.
Aspheric ReStor Lens is FDA-Approved
This new artificial lens, which often can restore sight at near, intermediate, and distant ranges following cataract surgery, has received United States Food and Drug Administration approval. Although the ReStor implant is new to the United States, it has had the CE Mark in Europe (highest certification in Europe, a designation similar to UL – underwriters labs – in the United States) and there are many thousands already implanted worldwide. The FDA clinical studies supporting its approval showed that 80% of patients who received the Aspheric ReStor lens did not use glasses for any activities after cataract surgery.
FDA clinical trials and results:
The exceptional visual performance of the ReStor lens was independent of pupil size and was accomplished by the optics of the lens, without physical movement of the lens inside the eye, making visual outcomes highly predictable. This is the first time this level of spectacle independence has been achieved!
Approved for use in Europe since April 4, 2003, the ReStor lens received FDA approval on March 23, 2005. During clinical trials, 566 people received the ReStor lens. The ReStor is made of the exact type of acrylic lens material that has been in used in cataract surgery for years, in many thousands of patients.
In an FDA Study:
- 80% of patients who had cataract surgery with the ReStor IOL in both eyes NEVER wore glasses. Only 3% of patients always wore glasses.
- 84% of patients receiving the ReStor lens in both eyes achieved distance visual acuity of 20/25 or better, and near visual acuity of 20/32 or better without glasses.
- 94% of patients who had ReStor put in both eyes, said they would have the surgery again.
During U.S. clinical trials, the results with ReStor were remarkable:
- 99% of patients could see well enough to drive a car without glasses or contacts
- 97% of patients could read the newspaper without reading glasses or bifocals
- 90% of patients could shave or put on makeup without glasses or contacts
- 74% of patients could read stock quotes in the Wall Street Journal without reading glasses or bifocals.